MARY BALLARD BROUSSARD (NPI# 1154892982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154892982 |
| Entity Type | Individual |
| Full Name | MARY BALLARD BROUSSARD |
| Credential | OTR |
| Practice Address |
704 Longmire Rd Ste 101 Conroe TX 77304-1850 |
| Mailing Address |
805 Yellow Birch Ln Conroe TX 77304-1993 |
| Practice Telephone | 9853738018 |
| Mailing Telephone | 9853738018 |
| Enumeration Date | 2018-12-05 |
| Last Update Date | 2018-12-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225X00000X | Occupational Therapist | OTT.200764 | LA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 225X00000X | Occupational Therapist | 119236 | TX | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801227210 | Mary Elizabeth Broussard | Occupational Therapist | 2655 N. Causeway Blvd Suite D, Integrative Touch Pediatric Occupational Therapy, Mandeville, LA 70471 | 2013-12-11 |
| 1386837953 | Mary Elizabeth Broussard | Occupational Therapist | 107 Briarmeadow Dr, Lafayette, LA 70508-7210 | 2007-08-27 |
| 1285844571 | Mary Jo Broussard | Nurse Practitioner | 1541 Tulane Ave, New Orleans, LA 70112-2821 | 2007-05-23 |
| Street Address |
704 LONGMIRE RD STE 101 |
| City | CONROE |
| State | TX |
| Zip Code | 77304-1850 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710996335 | Beyond Boundaries Therapy Center, Pllc | Clinic/Center | 704 Longmire Rd Ste 101, Conroe, TX 77304-1850 | 2006-08-05 |
| 1194372375 | Suzanne Stiles | Speech-Language Pathologist | 704 Longmire Rd Ste 101, Conroe, TX 77304-1850 | 2019-08-21 |
| 1659939908 | Kalli Nicole Kallies | Occupational Therapist | 704 Longmire Rd Ste 101, Conroe, TX 77304-1850 | 2019-06-02 |
| 1043788052 | Ashlain Dunkin | Speech-Language Pathologist | 704 Longmire Rd Ste 101, Conroe, TX 77304-1850 | 2018-11-07 |
| 1558884874 | Karina Trujillo | Speech-Language Pathologist | 704 Longmire Rd Ste 101, Conroe, TX 77304-1850 | 2017-07-18 |
| 1174925614 | Ashley Kaye Millar | Occupational Therapist | 704 Longmire Rd Ste 101, Conroe, TX 77304-1850 | 2014-09-16 |
| 1245651397 | Abigail Dillingham | Specialist/Technologist | 704 Longmire Rd Ste 101, Conroe, TX 77304-1850 | 2013-12-16 |
| 1972851434 | Robin Lucadou | Occupational Therapy Assistant | 704 Longmire Rd Ste 101, Conroe, TX 77304-1850 | 2012-08-15 |
| 1942558499 | Tana Wade | Speech-Language Pathologist | 704 Longmire Rd Ste 101, Conroe, TX 77304-1850 | 2012-08-15 |
| 1518214261 | Minnie Alice Baker | Occupational Therapy Assistant | 704 Longmire Rd Ste 101, Conroe, TX 77304-1850 | 2012-08-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194348649 | Neuropsychiatric Hospital of Greater Houston, LLC | Psychiatric Hospital | 1317 South Loop Road 336 West, Conroe, TX 77304 | 2020-05-19 |
| 1780148676 | Muve - Conroe Ambulatory Surgical Center, LLC | Clinic/Center | 1246 N Farm To Market 3083 Rd W, Conroe, TX 77304 | 2019-01-25 |
| 1922591411 | Bradley Leiker II | Dentist | 381 South Loop 336 West Suite 500, Conroe, TEXAS 77304 | 2018-06-11 |
| 1598266009 | Chapman Pain Consultants | Anesthesiology | 4015 I45 North, Suite 230-1, Conroe, TX 77304 | 2018-02-21 |
| 1063932366 | Jonathan Garcia | Specialist/Technologist | 1716 Summergate Drive, Conroe, TX 77304 | 2017-06-27 |
| 1932634169 | 3083 Imaging LLC | Clinic/Center | 1246 N Fm 3083 West, Conroe, TX 77304 | 2017-04-25 |
| 1881138758 | Bolt Urgent Care and Imaging Center, LLC | Clinic/Center | 1246 Fm 3083 West, Conroe, TX 77304 | 2016-12-13 |
| 1497106272 | The Rio At Conroe, LLC | Skilled Nursing Facility | 604 South Conroe Medical Drive, Conroe, TX 77304 | 2016-06-23 |
| 1093165615 | Melanie Kay Plaster | Behavioral Analyst | 2626 Silver Shadow, Conroe, TX 77304 | 2016-06-14 |
| 1508249798 | Conroe Willis Family Medicine, Pllc | Family Medicine | 4015 I 45 N Ste 220, Conroe, TX 77304 | 2015-07-07 |
| Find all providers in zip 77304 | ||||
| Taxonomy Code | 225X00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235743790 | Little Sprouts Occupational Therapy | Occupational Therapist | 13240 Autumn Ash Dr, Conroe, TX 77302-3143 | 2020-09-02 |
| 1609419803 | Adetunji Abiodun Adeleke | Occupational Therapist | 387 Oak Stream Dr, Conroe, TX 77304-5628 | 2019-10-21 |
| 1164999256 | Lauren Riley | Occupational Therapist | 11014 Oak Cliff Ct, Conroe, TX 77304-1677 | 2018-10-27 |
| 1992289565 | Maylah Villamiel | Occupational Therapist | 9941 Cassowary Dr, Conroe, TX 77385-3707 | 2018-09-19 |
| 1083098826 | Mandi Fowlkes | Occupational Therapist | 502 River Pointe Dr, Conroe, TX 77304-2838 | 2015-07-10 |
| 1003052564 | Kelsey Renae James | Occupational Therapist | 953 Doire Dr, Conroe, TX 77301-4136 | 2009-01-05 |
| 1093762932 | Sandra S Bartlett | Occupational Therapist | 3205 W Davis, Conroe, TX 77304 | 2006-05-27 |
| 1144853128 | Melissa Gardner | Occupational Therapist | 1600 Grand Lake Dr, Conroe, TX 77304-2834 | 2020-02-18 |
| 1992335012 | Segie Kieffer | Occupational Therapist | 1600 Grand Lake Dr, Conroe, TX 77304-2834 | 2020-01-16 |
| 1497397087 | Leandra Czaplicki | Occupational Therapist | 2019 N Frazier St, Conroe, TX 77301-1233 | 2019-10-15 |
| Find all providers in CONROE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.